characteristics of the bacteriaGBS colonization by vaginal-rectal culture at 35-37 weeks gestation is recommended to identify colonized woman who require ★intrapartum penicillin/ampicillin to prevent neonatal GBS sepsis, pneumonia and meningitis
women with heavy colnization (eg. asymptomatic bacteriuria) needs ampicillin (★)regardless of screening status or rectovaginal culture results
How long do water soluble vitamins stay in the body?all are washed out easily from body except for B12 and B9
B12 stored in liver for 3-4 years(depletion will take longer)
☆B9 stored in liver for 3-4 months
→★folate deficiency arises far more quickly biochemistryUWorldUWorld step2CK Jul 18, 2019, 2:27 AM HirotoShishido
restless leg syndrome
cause, treatmentworse at rest/nighttime
relieved by movement
idiopathic, 国試iron deficiency, uremia, diabetes(especially with neuropathy), ★multiple sclerosis
Avoidance of aggravating factors (eg, alcohol, sleep deprivation, antipsychotics)
placental aromatase deficiencyInability to synthesize estrogens from androgens.
Masculinization of female (46,XX DSD) infants (ambiguous genitalia),serum testosterone and androstenedione.
☆★Can present with maternal virilization during pregnancy (fetal androgens cross the placenta). reproductiveUWorldUWorld step2CK Apr 8, 2020, 5:50 AM HirotoShishido
presentation of fibrocystic changesdiffuse small cysts(black arrow) with or without papillary apocrine metaplasia
what should be carefully done about the use of exogenous insulin to the patient with CKDChronic kidney disease
Patients taking exogenous insulin are at increased risk of hypoglycemia if there is no decrease in dosage to compensate for renal failure. In light of this patient's worsening CKD, his symptomatic hypoglycemia is likely due to ☆reduced renal insulin clearance and a prolonged insulin effect. renalUWorldUWorld step2CK Mar 4, 2020, 2:17 AM HirotoShishido
treatment for cluster, migrane, tension, trigeminal neuralgiacluster→ acute(abortive): SC sumatriptan, ★100% O2
prophylaxis(preventive): verapamil (Ca blocker)
focal nodular hyperplasia(NFH)
common in female, age 20-50
regenerative reaction to hyperperfusion from anomalous arteries at center of nodule
☆lighter than normal liver tissue and lobulated with stellate scar from which ☆fibrous septate radiates to the periphery
helical CT scan (which evaluates the mass during different phases of vascular contrast) generally reveals a hyperdense lesion (ie, filled with contrast during hepatic arterial phase) and a ★central scar.
